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[Dementia in Whipple's disease?: relevance of infectious etiologies]
History And Clinical Findings:
A 69-year old patient who had been treated for joint pain over a long time was admitted because of weight loss and dementia. He was confused and cachectic with edema and skin hyperpigmentation.
Investigations:
Laboratory findings indicated chronic infection. Duodenal biopsy revealed Whipple's disease. The PCR of cerebrospinal fluid for Tropheryma whipplei was negative.
Treatment And Course:
During treatment with ceftriaxon and intravenous fluid therapy the patient's mental state improved. However his motoric state remained insufficient.
Conclusion:
Whipple's disease should be considered in dementia, even more in previous "rheumatic symptoms", in order to avoid ineffective (immunosuppressive) treatment with unfortunate consequences.
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